1
|
Goh CL, Kang HY, Morita A, Zhang C, Wu Y, Prakoeswa CRS, Sau NH, Kerob D, Flament F, Wei L. Awareness of sun exposure risks and photoprotection for preventing pigmentary disorders in Asian populations: Survey results from three Asian countries and expert panel recommendations. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12932. [PMID: 38059515 DOI: 10.1111/phpp.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND In this article, we review and discuss the photoprotection behavior of Asians based on the literature, along with a subanalysis of an original online survey, and make recommendations to optimize photoprotection for Asian populations to prevent photoaging and pigmentary disorders. METHODS An international panel of eight dermatologists from Asia (China, Korea, Japan, Singapore, Indonesia, and Vietnam) met to discuss sunscreen photoprotection for Asian patients. Additionally, a subanalysis of an online survey by 3000 respondents from three Asian countries (China, Indonesia, and Japan) investigated general public awareness and attitudes to sun exposure. RESULTS A pre-meeting survey of the eight experts from Asia showed key concerns of Asian patients consulting dermatologists are pigmentary disorders, especially actinic/senile lentigo, post-inflammatory hyperpigmentation, melasma, vitiligo, and Hori's nevus. The survey subanalysis of participants from China, Indonesia, and Japan with predominantly Fitzpatrick skin types (FST) II to IV revealed that they are particularly concerned about sun exposure causing photoaging and pigmentary disorders. Most of the respondents indicated they have limited knowledge on sunlight radiation and appropriate sunscreen protection factors. Only 22%, 13%, and 3% for China, Indonesia, and Japan, respectively, systematically use multiple protective measures (using sunscreen, avoiding midday sun, staying in the shade, wearing a hat, protective clothing, and sunglasses) when exposed to the sun. CONCLUSIONS Further education is needed for Asian populations on the importance of comprehensive daily photoprotection, including broad-spectrum sunscreen, with high UVA and visible light protection, to reduce and prevent photoaging and pigmentary disorders.
Collapse
Affiliation(s)
| | - Hee Young Kang
- Department of Dermatology, Ajou University School of Medicine, Suwon, South Korea
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Chengfeng Zhang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Wu
- Department of Dermatology, Peking University First Hospital, Beijing, China
| | - Cita Rosita Sigit Prakoeswa
- Department of Dermatology and Venerology, Faculty of Medicine, Universitas Airlangga - Dr Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Nguyen Huu Sau
- Hanoi Medical University and National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Delphine Kerob
- Laboratoire Dermatologique La Roche-Posay, Levallois-Perret, France
| | | | - Liu Wei
- Department of Dermatology, The General Hospital of Air Force PLA, Beijing, China
| |
Collapse
|
2
|
Flament F, Saint-Leger D. Photoaging's portrait: The road map towards its photoprotection. Int J Cosmet Sci 2023; 45 Suppl 1:33-44. [PMID: 37638664 DOI: 10.1111/ics.12903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/19/2023] [Accepted: 04/26/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE To summarize key research published by the author's group, dealing with skin photoaging and its photoprotection. MATERIALS AND METHODS Two methodologies (standard photographs and selfies imaging) resulting from referential skin ageing atlases were applied on 2487 subjects of different ancestries, ages and gender. These aimed at first to best assess and grade the variable severities of some facial signs (texture/wrinkles, pigmentary spots, sagging and vascular disorders) that occur progressively during the photoaging process. Second, such methodologies were used to record the benefits brought by a photoprotective regimen (671 women and men). RESULTS In all studied ancestries, each facial sign show an increase severity along decades, at its own pace, some showing a linear like progression, whereas some plateau at early ages. These changes differed according to skin innate colour (phototype) and with individual behaviours vis-à-vis sun exposures, more so among European women than North-East Asian women. An effect of gender (less severe alterations) was observed on Chinese men, as compared to Chinese women. Pigmentary disorders were found hallmarks of photo-aged North-East Asian women. Globally, photoaging impact the apparent age of the different subjects. The counteracting effects of strong topical Photoprotective regimens were evidenced along a 6-month seasonality in Chinese and French women or 1-year period in Brazilian women with phototypes II to VI. Photoprotection led to a more even skin complexion among Indian subjects with pigment irregularities. CONCLUSION Two factors clearly hamper a better assessment of the efficiency of photoprotection of the sun-induced cutaneous ageing: short durations (months) of the studies with regard to the global fate of photoaging by decades and the number of studied subjects, limited to hundreds for practical reasons. The methodology based on the automatic analysis of facial signs through selfies images could theoretically bypass both factors, allowing thousands of subjects to be studied along years.
Collapse
|
3
|
Fujiwara R, Muta K, Izutsu Y, Hatao M. The effect of on-site application density on the UV protection efficacy of sunscreens. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:259-265. [PMID: 34695251 DOI: 10.1111/phpp.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/28/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Sun protection factor (SPF) and UVA protection factor (UVAPF) are performance indicators consumers recognize for UV protective cosmetics such as sunscreens. However, on-site application density affects actual UV protection, despite these indicators. To understand actual UV protection better, a more reliable manner is needed to verify application density for further discussion of photoprotection efficacy regarding public health. OBJECTIVES To estimate the UV protective efficacy of sunscreen in actual use based on the application density of UV protective cosmetics and the analysis of UV protective effect modulated by application density. METHOD The subjects applied the SPF-labeled sunscreens as usual. We measured the application amount and area including any amount on their hands to calculate the average application density on the face. Also, sunscreens were applied at densities of 0.5, 1.0, and 2.0 mg/cm2 . The SPF values were measured at each application site to evaluate the effect of application density on photoprotection efficacy. RESULT We established a method of measuring application density utilizing three-dimensional photograph analysis. The median application density of the sunscreen applied in actual use was 1.33 mg/cm2 . The measured SPF values decreased in association with the decreased application density of sunscreens. Based on the estimate assuming the first-order correlation, the SPF value required to get the protective effect equivalent to a sunscreen with SPF 15, 30, or 50 at 2 mg/cm2 was calculated to be 23.8, 47.5, and 79.2, respectively, with the application density of 1.33 mg/cm2 . CONCLUSION We demonstrated a reasonable procedure for estimating the photoprotection efficacy of sunscreens on the face. A suggestion was made to consider the application density for further discussion of photoprotection among consumers, especially for the long term with respect to public health.
Collapse
Affiliation(s)
- Rumiko Fujiwara
- Japan Cosmetic Industry Association, Tokyo, Japan
- Shiseido Global Innovation Center, Yokohama, Japan
| | - Keiko Muta
- Japan Cosmetic Industry Association, Tokyo, Japan
- Shiseido Global Innovation Center, Yokohama, Japan
| | - Yukiko Izutsu
- Japan Cosmetic Industry Association, Tokyo, Japan
- Nikko Chemicals Co., Ltd., Tokyo, Japan
| | - Masato Hatao
- Japan Cosmetic Industry Association, Tokyo, Japan
| |
Collapse
|
4
|
Wong QYA, Chew FT. Defining skin aging and its risk factors: a systematic review and meta-analysis. Sci Rep 2021; 11:22075. [PMID: 34764376 PMCID: PMC8586245 DOI: 10.1038/s41598-021-01573-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/27/2021] [Indexed: 01/01/2023] Open
Abstract
Skin aging has been defined to encompass both intrinsic and extrinsic aging, with extrinsic aging effected by environmental influences and overlaying the effects of chronological aging. The risk factors of skin aging have been studied previously, using methods of quantifying skin aging. However, these studies have yet to be reviewed. To better understand skin aging risk factors and collate the available data, we aimed to conduct a systematic review and meta-analysis. We conducted our systematic review in compliance with Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. Embase, PubMed and Web of Science databases were searched in October 2020 using specific search strategies. Where odds ratios were reported, meta-analyses were conducted using the random effects model. Otherwise, significant factors were reported in this review. We identified seven notable risk factors for various skin aging phenotypes: age, gender, ethnicity, air pollution, nutrition, smoking, sun exposure. This review's results will guide future works, such as those aiming to examine the interaction between genetic and environmental influences.
Collapse
Affiliation(s)
- Qi Yi Ambrose Wong
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, Faculty of Science, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Fook Tim Chew
- Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Department of Biological Sciences, Faculty of Science, National University of Singapore, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore.
| |
Collapse
|
5
|
Passeron T, Lim HW, Goh CL, Kang HY, Ly F, Morita A, Ocampo Candiani J, Puig S, Schalka S, Wei L, Dréno B, Krutmann J. Photoprotection according to skin phototype and dermatoses: practical recommendations from an expert panel. J Eur Acad Dermatol Venereol 2021; 35:1460-1469. [PMID: 33764577 PMCID: PMC8252523 DOI: 10.1111/jdv.17242] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/10/2021] [Indexed: 12/14/2022]
Abstract
Increasing evidence on the impact of the different wavelengths of sunlight on the skin demonstrates the need for tailored recommendations of sunscreen according to skin phototype and dermatoses, which is now possible due to advances in the filters and formulations of sunscreens. A selective literature search was performed by an international expert panel, focusing on the type of sunscreen to recommend for photoaging, skin cancers, photodermatoses, pigmentary disorders and skin inflammatory disorders. Protection against ultraviolet (UV)B is especially important for light skin as there is a high risk of sunburn, DNA damage and skin cancers. Darker skin may be naturally better protected against UVB but is more prone to hyperpigmentation induced by visible light (VL) and UVA. Protection against UVA, VL and infrared A can be helpful for all skin phototypes as they penetrate deeply and cause photoaging. Long‐wave UVA1 plays a critical role in pigmentation, photoaging, skin cancer, DNA damage and photodermatoses. Adapting the formulation and texture of the sunscreen to the type of skin and dermatoses is also essential. Practical recommendations on the type of sunscreen to prescribe are provided to support the clinician in daily practice.
Collapse
Affiliation(s)
- T Passeron
- Department of Dermatology, Côte d'Azur University, Nice University Hospital Center, Nice, France.,INSERM U1065, C3M, Côte d'Azur University, Nice, France
| | - H W Lim
- Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
| | - C-L Goh
- National Skin Centre, Singapore, Singapore
| | - H Y Kang
- Department of Dermatology, Ajou University School of Medicine, Suwon, South Korea
| | - F Ly
- Department of Dermatology, Cheikh Anta Diop Dakar University, EPS Institute of Social Hygiene, Dakar, Senegal
| | - A Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - J Ocampo Candiani
- Department of Dermatology, Medical Faculty University Hospital of Nuevo León, Monterrey, Mexico
| | - S Puig
- Melanoma Unit, Dermatology Department, Barcelona University Hospital Clinic, Barcelona, Spain
| | - S Schalka
- Medcin Skin Research Center and Biochemistry Department, Chemistry Institute of São Paulo University, São Paulo, Brazil
| | - L Wei
- Department of Dermatology, The General Hospital of Air Force PLA, Beijing, China
| | - B Dréno
- Department of Dermato-Oncology, CIC 1413, CRCINA, Nantes University Hospital Center, Nantes, France
| | - J Krutmann
- IUF Leibniz Research Institute for Environmental Medicine, Dusseldorf, Germany.,Medical Faculty, Heinrich-Heine-University, Dusseldorf, Germany
| |
Collapse
|
6
|
Krutmann J, Schalka S, Watson REB, Wei L, Morita A. Daily photoprotection to prevent photoaging. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 37:482-489. [PMID: 33896049 DOI: 10.1111/phpp.12688] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/10/2021] [Accepted: 04/19/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Extrinsic skin aging or photoaging was previously thought to be almost exclusively due to solar ultraviolet (UV) radiation. However, recent literature has described other contributing factors and clarification is thus required as to what extent and what type of daily photoprotection is needed to mitigate extrinsic skin aging. METHODS We reviewed the existing scientific evidence on daily photoprotection, and specific requirements at the product level, to prevent extrinsic skin aging. We critically reviewed the existing evidence on potential ecological and toxicological risks which might be associated with daily photoprotection. RESULTS Evidence shows that broad protection against the entire solar range of UVB, UVA, UVA1, visible light, and short infrared (IRA) is required to prevent extrinsic aging. Other exposome factors, such as air pollution and smoking, also contribute to skin aging. Daily broad-spectrum sunscreen photoprotection should thus contain antioxidant ingredients for additional benefits against UV, IRA, and pollution-induced oxidative stress as well as anti-aging active ingredients to provide clinical benefits against skin aging signs, such as wrinkles and dark spots. Broad-spectrum sunscreen containing pigments, such as iron oxide, may be required for melasma prevention. There is no conclusive clinical evidence that daily sunscreen use is unsafe or that it compromises vitamin D synthesis. CONCLUSION Daily use of broad-spectrum sunscreen containing antioxidant and anti-aging active ingredients can effectively reduce extrinsic aging.
Collapse
Affiliation(s)
- Jean Krutmann
- IUF Leibniz Research Institute for Environmental Medicine, Dusseldorf, Germany.,Medical faculty, Heinrich-Heine-University, Dusseldorf, Germany
| | - Sérgio Schalka
- Medcin Skin research Center and Biochemistry Department, Chemistry Institute of São Paulo University, São Paulo, Brazil
| | - Rachel Elizabeth Beatrice Watson
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Salford, UK.,Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Liu Wei
- Department of Dermatology, The General Hospital of Air Force PLA, Beijing, China
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| |
Collapse
|
7
|
Flament F, Velleman D, Yamashita E, Nicolas A, Yokoyama E, Itaya A, Zhang Y, Jiang R, Aarabi P, Abric A, Nakada A, Sagawa Y, Nishihara H, Morita A, Cassier M, Delaunay C. Japanese experiment of a complete and objective automatic grading system of facial signs from selfie pictures: Validation with dermatologists and characterization of changes due to age and sun exposures. Skin Res Technol 2020; 27:544-553. [DOI: 10.1111/srt.12982] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Affiliation(s)
| | | | | | | | | | | | - Yuze Zhang
- ModiFace – A L'Oréal Group Company Toronto Canada
| | - Ruowei Jiang
- ModiFace – A L'Oréal Group Company Toronto Canada
| | | | | | - Aya Nakada
- Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Yoko Sagawa
- Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Haruna Nishihara
- Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | | | - Caroline Delaunay
- L'Oréal Research and Innovation Clichy France
- L'Oréal Research and Innovation Tokyo Japan
| |
Collapse
|
8
|
Flament F, Velleman D, Yamamoto S, Nicolas A, Udodaira K, Yamamoto S, Morimoto C, Belkebla S, Negre C, Delaunay C. Clinical impacts of sun exposures on the faces and hands of Japanese women of different ages. Int J Cosmet Sci 2019; 41:425-436. [DOI: 10.1111/ics.12555] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/14/2019] [Indexed: 01/16/2023]
Affiliation(s)
- F. Flament
- L’Oréal Research and Innovation 9, Rue Pierre Dreyfus 93400 Clichy France
| | - D. Velleman
- L’Oréal Research and Innovation 3-2-1 Takatsu-ku Sakado213 012 Kawasaki-Shi Kanagawa Japan
| | - S. Yamamoto
- L’Oréal Research and Innovation 3-2-1 Takatsu-ku Sakado213 012 Kawasaki-Shi Kanagawa Japan
| | - A. Nicolas
- L’Oréal Research and Innovation 3-2-1 Takatsu-ku Sakado213 012 Kawasaki-Shi Kanagawa Japan
| | - K. Udodaira
- L’Oréal Research and Innovation 3-2-1 Takatsu-ku Sakado213 012 Kawasaki-Shi Kanagawa Japan
| | - S. Yamamoto
- L’Oréal Research and Innovation 3-2-1 Takatsu-ku Sakado213 012 Kawasaki-Shi Kanagawa Japan
| | - C. Morimoto
- L’Oréal Research and Innovation 3-2-1 Takatsu-ku Sakado213 012 Kawasaki-Shi Kanagawa Japan
| | - S. Belkebla
- L’Oréal Research and Innovation 9, Rue Pierre Dreyfus 93400 Clichy France
| | - C. Negre
- L’Oréal 62, Quai Charles Pasqua 92300 Levallois‐Perret France
| | - C. Delaunay
- L’Oréal Research and Innovation 3-2-1 Takatsu-ku Sakado213 012 Kawasaki-Shi Kanagawa Japan
| |
Collapse
|
9
|
Nawaz M, Khan HMS, Akhtar N, Jamshed T, Qaiser R, Shoukat H, Farooq M. Photodamage and Photoprotection: An
In vivo
Approach Using Noninvasive Probes. Photochem Photobiol 2019; 95:1243-1248. [DOI: 10.1111/php.13113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 04/26/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Mehwish Nawaz
- Faculty of pharmacy and alternative medicine The Islamia University of Bahawalpur Bahawalpur Pakistan
| | - Haji Muhammad Shoaib Khan
- Faculty of pharmacy and alternative medicine The Islamia University of Bahawalpur Bahawalpur Pakistan
| | - Naveed Akhtar
- Faculty of pharmacy and alternative medicine The Islamia University of Bahawalpur Bahawalpur Pakistan
| | - Talha Jamshed
- Faculty of pharmacy and alternative medicine The Islamia University of Bahawalpur Bahawalpur Pakistan
| | - Rubina Qaiser
- Faculty of pharmacy and alternative medicine The Islamia University of Bahawalpur Bahawalpur Pakistan
| | - Hina Shoukat
- Faculty of pharmacy and alternative medicine The Islamia University of Bahawalpur Bahawalpur Pakistan
| | - Mehrin Farooq
- Faculty of pharmacy and alternative medicine The Islamia University of Bahawalpur Bahawalpur Pakistan
| |
Collapse
|